Jerome M Blake, MD
Pediatrics, Neurodevelopmental Disabilities in Sioux Falls, SD. Individual provider (NPI-1).
NPI number1699760546
StatusActive
Last updated in NPPESMar 13, 2015
Details
- NPI
- 1699760546
- Entity type
- Individual (NPI-1)
- Name
- Jerome M Blake
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 16, 2005
- Last updated
- Mar 13, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080P0008X | Pediatrics, Neurodevelopmental Disabilities | 2228 | SD | Yes |
Practice location
1600 W 22nd StSioux Falls, SD 57105-1521
Phone 605-312-1000 · Fax 605-312-1001
Mailing address
Po Box 5074Sioux Falls, SD 57117-5074
Phone 605-328-7180 · Fax 605-328-7177
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